Articles: postoperative.
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Paediatric anaesthesia · Nov 2014
Randomized Controlled TrialThe addition of tramadol to the standard of IV acetaminophen and morphine infusion for postoperative analgesia in neonates offers no clinical benefit: a randomized placebo-controlled trial.
Tramadol is used following neonatal cardiac and general surgery. However, its ability to opioid-spare or facilitate earlier extubation in postoperative neonates is unquantified. ⋯ Tramadol's addition to standard analgesia in this small group of postsurgical neonates did not appear to have any positive effect on time to extubation, morphine or midazolam exposure, or pain scores. This questions the benefit of tramadol for postsurgical neonates. Importantly, no seizures occurred in these ill neonates who may potentially be at greater risk of tramadol toxicity compared with adults.
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Randomized Controlled Trial
Erythropoietin and Protection of Renal Function in Cardiac Surgery (the EPRICS Trial).
To date, there are no known methods for preventing acute kidney injury after cardiac surgery. Increasing evidence suggests that erythropoietin has renal antiapoptotic and tissue protective effects. However, recent human studies have shown conflicting results. The authors aimed to study the effect of a single high-dose erythropoietin preoperatively on renal function after coronary artery bypass grafting in patients with preoperative impaired renal function. ⋯ Intravenous administration of a single high-dose (400 IU/kg) erythropoietin did not have a renal protective effect on patients with reduced kidney function undergoing coronary artery bypass surgery.
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Randomized Controlled Trial
Bispectral index guided titration of sevoflurane in on-pump cardiac surgery reduces plasma sevoflurane concentration and vasopressor requirements: A prospective, controlled, sequential two-arm clinical study.
Electroencephalographic-based monitoring systems such as the bispectral index (BIS) may reduce anaesthetic overdose rates. ⋯ BIS-guided titration of sevoflurane reduces the SPC and decreases noradrenaline administration compared with routine care during on-pump cardiac surgery.
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J Minim Invasive Gynecol · Sep 2014
Randomized Controlled TrialEffects of peritoneal ropivacaine nebulization for pain control after laparoscopic gynecologic surgery.
To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. ⋯ Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance.
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Randomized Controlled Trial
Analgesic efficacy of pre-operative stellate ganglion block on postoperative pain relief: a randomised controlled trial.
This small trial found that pre-operative stellate ganglion block before upper-limb orthopaedic surgery significantly reduced both 24 h tramadol consumption and pain at rest for up to 6 hours, although the later was of borderline clinical significance.
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